POS1338 PHARMAKON OR THE ART THAT HEALS: TRANS-DISCIPLINARY ARTISTIC-TRANSFORMATIVE WORKSHOPS FOR FIBROMYALGIA SYNDROME
Authors: C. Villani, M. Sapio, V. Giorgi, P. Sarzi-Puttini
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fibromyalgia syndrome (FMS) is a widespread chronic pain syndrome with many associated symptoms. It is frequently related to a traumatic event (1), strong and of short duration, or slight but protracted over time. A multidisciplinary therapeutic approach is recommended by international guidelines. The transformative experience (TE) allows for a profound and immediate change that differs from linear and gradual psychological change; this helps create novel responses to the same initial thoughts and actions, thereby breaking the maladaptive emotional/behavioral loop elicited by chronic stress and trauma (2), creating a sort of "virtuous" cycle, adaptive rather than maladaptive and long-lasting. In this study, TE was specifically elicited through transformative art (TA), an intrinsically transdisciplinary tool, in different ways in the three arms of the study. <h3>Objectives</h3> Validation of the efficacy (in terms of quality of life and sleep, self-esteem, self-efficacy) of transdisciplinary TA workshops in patients with FMS. <h3>Methods</h3> Prospective observational study lasting 8 months (February-October, 2021), in which the effectiveness of three different TA workshops in patients with FMS was evaluated: in group 1 participants were encouraged to review their autobiography and illness in a humorous sense; in group 2 participants were guided to express their own realities of chronically ill patients in poetry; group 3 was based on the guided narration of works of art according to visual thinking strategies integrated with the principles of narrative medicine. Patients were divided into the three laboratories according to their preference. Tests were administered at baseline and post-workshop. The activities took place entirely online. <h3>Results</h3> 109 FM patients completed the study (n=3 males, mean age 52.9, mean years from diagnosis 11.2 [SD 8.6]). No differences were found among the three groups at baseline in terms of clinimetric variables. Data analysis made by a Wlicoxon non-parametric test (WNPT) of the three groups in conjunction showed a statistically significant improvement of the Pittsburgh Sleep Quality Index (PSQI) (p&lt;0.05), Response to Stressful Experiences Scale (RSES) (p&lt;0.05), World Health Organization- Five Well-Being Index (WHO-5) (p&lt;0.001) and Global Health scale (GH) (p&lt;0.05). No significant difference was found for The Mindful Attention Awareness Scale (MAAS) (p=0.2663). A WPNT was performed to compare baseline and final results of the three groups separately. The best performance was seen in Group 1, since patients ameliorated in almost all parameters: PSQI (p&lt;0.05), GH (p&lt;0.05), SAP dimension 1 (p&lt;0.05), 2 (p&lt;0.05) and 4 (p &lt;0.05), WHO-5 (p=0.0013). MAAS (p=0.895), RSES (p=0.0673) and SAP dimension 3 (p=0.0573) resulted nonsignificant, although very close to significance. Sleep (p&lt;0.05) and the 3rd dimension of SAP (p&lt;0.05) improved in patients of Group 2; whilst self-esteem (p&lt;0.05) and WHO-5 (p&lt;0.05) did in Group 3. <h3>Conclusion</h3> Our research shows that art, experienced as TA, leads to significant improvements of the psychophysical condition of FMS patients. TA can be seen as a crucial mediator for overcoming the trauma/stressors, probably through the generation of "pivotal mental states" (PIMS), defined as a "hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation" [3]. <h3>References</h3> [1]Miró, E., Martínez, M.P., Sánchez, A.I. and Cáliz, R. (2020), Clinical Manifestations of Trauma Exposure in Fibromyalgia: The Role of Anxiety in the Association Between Posttraumatic Stress Symptoms and Fibromyalgia Status. JOURNAL OF TRAUMATIC STRESS, 33: 1082-1092 [2]Christopher M. (2004) A broader view of trauma: A biopsychosocial-evolutionary view of the role of the traumatic stress response in the emergence of pathology and/or growth. Clinical Psychology Review; 24(1):75-98. [3]Brouwer, Ari, and Robin Lester Carhart-Harris. "Pivotal mental states." Journal of Psychopharmacology 35.4 (2021): 319-352. <h3>Acknowledgements</h3> The initiative was carried out in collaboration with AISF odv and with the LabSud association, with the Civic Museum of Castelbuono and the Cultural Heritage Department of the Sicily Region, the Department of Cultural Heritage and the Rice Museum of Palermo and obtained the patronage of the Municipality of Castelbuono, the Academy of Fine Arts of Palermo, the Order of Doctors of Palermo, ANMIRS, ISTUD and SIMeN. <h3>Disclosure of Interests</h3> None Declared.